摘要
目的探讨对行股骨头置换术的老年患者实施腰硬联合麻醉与全麻对疗效及术后患者认知功能的影响。方法选取该院2014年2月—2017年2月期间普外科收治的股骨颈骨折需行股骨头置换术的老年患者90例为研究对象,按照随机数字表法分为A、B两组(n=45),其中A组实施腰硬联合麻醉,B组实施全身麻醉,对两组患者的手术效果、认知功能等进行对比。结果手术完毕后B组心率及收缩压的下降情况较A组显著(P<0.05)。其中B组心率为(78.21±5.20)次/min,收缩压为(125.94±10.48)mm Hg,A组心率为(77.82±5.03)次/min,收缩压为(126.72±11.59)mm Hg,两组患者呼吸及血氧饱和度在手术前后对比差异无统计学意义(P>0.05);A组患者麻醉起效时间(3.58±1.12)min、术后苏醒时间(93.69±31.32)min、应答时间(101.19±35.61)min均显著短于B组(P<0.05);A组患者围术期并发症发生率为8.89%,显著低于B组的33.33%(P<0.05);MMSE评分对比,术前两组患者对比差异无统计学意义(P>0.05),术后12 h、1 d及3 d对比两组均低于手术前(P<0.05),但A组评分显著高于B组(P<0.05)。结论对老年股骨头置换术患者实施腰硬联合麻醉能够保证患者生命体征平稳,减少麻醉起效时间,减少术后苏醒及应答时间,同时降低围术期并发症,降低患者认知功能障碍的发生。
Objective To study the effect of combined spinal and epidural anesthesia and general anesthesia on the curative effect and cognitive function of femoral head replacement in senile people. Methods 90 cases of senile patients for femoral head replacement in our hospital from February 2014 to February 2017 were selected and randomly divided into two groups, the group A and the group B were respectively treated with combined spinal and epidural anesthesia and general anesthesia, and the operation effect and cognitive function of the two groups were compared. Results After operation, the heart rate and decrease of systolic pressure in the group A were more obvious than those in the group A,（P〈0.05）, and the heart rate and systolic pressure in the group B and in the group B and in the group A were respectively（78.21±5.20）times/min,（125.94±10.48）mm Hg and（77.82±5.03）times/min,（126.72±11.59）mm Hg, and there was no statistically signficant difference in the respiration and oxygen saturation of blood before and after operation between the two groups（P〉0.05）, and the anesthesia onset time, postoperative awakening time, reply time in the group A were respectively（3.58 ±1.12）min,（93.69 ±31.32）min and（101.19 ±35.61）min, which were obviously shorter than those in the group B（P〈0.05）, and the incidence rate of complications during the perioperative period in the group A was obviously lower than that in the group B（8.89% vs 33.33%）（P〈0.05）, and there was no statistically signficant difference in the MMSE score between the two groups before surgery（P〉0.05）, and the indicators of the two groups in 12 h, 1 d and 3 d after surgery were lower than those before surgery（P〈0.05）, but the scores in the group A were obviously higher than those in the group B（P〈0.05）. Conclusion The implementation of combined spinal and epidural anesthesia in senile femoral head replacement patients can ensure the steady vital signs, reduce the anesthesia onset time, reduce the
作者
张凤伟
王玲伟
王娜
ZHANG Feng-wei;WANG Ling-wei;WANG Na(Department of Anesthesia,Caofeidian District Nanbao Development Zone Hospital,Tangshan,Hebei Province,063305 Chin)
出处
《系统医学》
2018年第4期42-45,共4页
Systems Medicine
关键词
腰硬联合麻醉
全身麻醉
老年患者
股骨头置换术
认知功能
Combined spinal and epidural anesthesia
General anesthesia
Senile patients
Femoral head replacement
Cognitive function
